Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

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State: Public
Version: author
Serval ID
serval:BIB_5235AEC57B36
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?
Journal
Plos One
Author(s)
Mahé I., Sterpu R., Bertoletti L., López-Jiménez L., Mellado Joan M., Trujillo-Santos J., Ballaz A., Hernández Blasco L.M., Marchena P.J., Monreal M.
Working group(s)
RIETE Investigators
Contributor(s)
Ameneiro E., Arcelus JI., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Blanco-Molina A., Bueso T., Casado I., Conget F., del Molino F., del Toro J., Falgá C., Fernández-Capitán C., Font L., Fuentes MI., Gallego P., García-Bragado F., García-Lorenzo MD., Gómez V., González J., González-Bachs E., Guil M., Gutiérrez J., Hernández L., Hernández-Huerta S., Jaras MJ., Jiménez D., Lecumberri R., Lobo JL., López-Jiménez L., López-Montes L., López-Reyes R., López-Sáez JB., Lorente MA., Lorenzo A., Luque JM., Madridano O., Marchena PJ., Martín M., Mellado M., Monreal M., Mora JM., Nauffal D., Nieto JA., Núñez MJ., Ogea JL., Paul H., Pedrajas JM., Peris ML., Porras JA., Riera-Mestre A., Rivas A., Rodríguez-Dávila MA., Román P., Rosa V., Ruiz-Giménez N., Ruiz J., Sahuquillo JC., Samperiz A., Sánchez R., Sánchez Muñoz-Torrero JF. , Soler S., Suriñach JM., Tiberio G., Tilván RM., Tolosa C., Trujillo-Santos J., Uresandi F., Valdés M., Valero B., Valle R., Vela J., Vidal G., Vilella V., Villalta J., Verhamme P., Peerlinck K., Wells P., Malý R., Hirmerova J., Kaletova M., Bertoletti L., Bura-Riviere A., Farge-Bancel D., Hij A., Mahe I., Merah A., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Zeltser D., Amitrano M., Apollonio A., Barillari G., Ciammaichella M., Dalla Valle F., Di Micco P., Duce R., Guida A., Maida R., Pasca S., Piovella C., Prandoni P., Rota L., Tiraferri E., Tonello D., Tufano A., Visonà A., Zalunardo B., Brinquinho M., Miranda D., Bosevski M., Kovacevic D., Alatri A., Bounameaux H., Calanca L.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
10
Number
6
Pages
e0128741
Language
english
Notes
Alatri A is a RIETE investigator
Abstract
Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision.
Pubmed
Web of science
Open Access
Yes
Create date
12/02/2016 13:47
Last modification date
02/06/2020 14:20
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